Table 1.

Interventions Commonly Used in Treating Patients With Binge-Eating Disorder

Treatment	Description
Psychological, behavioral, or both
CBT	Focuses on identifying relationships among thoughts, feelings, and behaviors; aims to reduce negative emotions and undesirable behavior patterns by changing negative thoughts about oneself and the world. CBT may be delivered in various forms according to the level of therapist involvement—e.g., from therapist engaged in all aspects of treatment (therapist-led CBT) to no therapist engagement (self-help CBT). In self-help CBT, the patient follows a treatment manual or book, either with the help of a facilitator (e.g., guided or structured self-help) or alone. CBT may be tailored to the patient by focusing on problematic eating-related cognitions and behaviors.
Dialectical behavior therapy	Focuses on increasing mindfulness and developing skills to improve emotion regulation, distress tolerance, and interpersonal relationships to help patients respond to stress and negative affect more effectively.
Interpersonal psychotherapy	Focuses on identifying and changing the role of interpersonal functioning in causing and maintaining negative mood, psychological distress, and unhealthy behaviors.
Behavioral weight loss	Incorporates various behavioral strategies to promote weight loss, such as restricting caloric intake and increasing physical activity.
Pharmacologic
Antidepressants	Selectively inhibit reuptake of neurotransmitters involved in regulating mood and appetite (i.e., dopamine, norepinephrine, and serotonin). Common examples include bupropion, citalopram, desipramine, duloxetine, fluoxetine, fluvoxamine, and sertraline, which are indicated for treating patients with depression.
Anticonvulsants	Indicated for treating patients with epilepsy, bipolar disorder, major depression, and migraines. Topiramate, a carbonic anhydrase inhibitor, is the most commonly used.
Antiobesity agents	Used to treat obesity. For example, orlistat inhibits pancreatic lipase and thus decreases fat absorption in the gut.
Central nervous system stimulants	Generally used to enhance or accelerate mental and physical processes; specifically used to treat attention deficit–hyperactivity disorder and certain sleep problems. Lisdexamfetamine, the only U.S. Food and Drug Administration–approved medication for binge-eating disorder, belongs to this class.

CBT = cognitive behavioral therapy.